NPIMap

Organization Active NPI

Glendale Healthcare Assoc., LLC

Doing business as Desert Sky Health and Rehabilitation

  • Skilled Nursing Facility
  • Glendale, AZ
National Provider Identifier
1033444633
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
OTC 3638 Issued in AZ
Legal business name
GLENDALE HEALTHCARE ASSOC., LLC
Doing business as
Desert Sky Health and Rehabilitation
Practice address
5125 N 58TH Ave
Glendale, AZ 85301-7453
Phone
(623) 931-5800
Fax
(623) 931-8776
NPI assigned
Oct 15, 2009
Last updated
Oct 15, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
GLENDALE HEALTHCARE ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tim Riter, COTA
Title
Director of Rehab
Phone
(623) 931-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X OTC 3638 AZ Primary

Addresses

Primary practice location

5125 N 58TH Ave
Glendale, AZ 85301-7453

Mailing address

5125 N 58TH Ave
Glendale, AZ 85301-7453
Phone (623) 931-5800

Other identifiers 2

IdentifierTypeStateIssuer
035092OtherAZMEDICARE
688070MedicaidAZ

Other names 1

  • Desert Sky Health and Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glendale Healthcare Associates LLC4 organizations share this tax ID, including this one
Part of
Glendale Healthcare Associates LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1033444633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 N 58TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853017453",
            "telephone_number": "623-931-5800",
            "fax_number": "623-931-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 N 58TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853017453",
            "telephone_number": "623-931-5800",
            "fax_number": "623-931-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE HEALTHCARE ASSOC., LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLENDALE HEALTHCARE ASSOCIATES, LLC",
        "enumeration_date": "2009-10-15",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "RITER",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "DIRECTOR OF REHAB",
        "authorized_official_telephone_number": "623-931-5800",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "OTC 3638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "035092",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688070",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Sky Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.